This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to colleagues, clients or customers, use the Reprints tool at the top of any article or visit: www.reutersreprints.com.

Penn Staters protest wellness program's steep fines

Fri, Aug 16 2013

By Sharon Begley

NEW YORK, Aug 15 (Reuters) - Matthew Woessner, associate
professor of political science at Pennsylvania State University,
doesn't smoke, spends an hour every day on the elliptical
trainer and eats (mostly) healthy food. But he draws the line at
new "wellness" steps required by his employer, such as filling
out a form that asks whether he examines his testicles every
month - and paying a $1,200 penalty if he doesn't comply.

An open letter Woessner wrote protesting the university's
2014 wellness requirements has sparked a protest by more than
2,000 faculty and staff employees at Penn State who argue that
it is coercive and unethical and ask that it be stopped.

Studies show the $1,200 annual penalty is one of the most
severe to be imposed by a U.S. employer, only 2 percent of which
use fines alone, rather than rewards, to push staff to undergo
medical testing, provide data on their health and otherwise
participate in wellness programs.

Most of the opposition to the program focuses on what
Woessner calls "the ethical ramifications of coercing employees
to turn over private health information" to companies running
the wellness program. But he and other faculty members have
recently been contacted by experts in workplace wellness,
pointing to studies showing that such programs, on average, save
employers little, if anything, in healthcare costs and may even
increase spending by forcing workers to undergo extra testing
and schedule additional doctor visits.

"That gives me the sense that the administration hasn't
weighed the program's costs, especially in employee morale and
threats to privacy, against its benefits, which might be very
small," said Woessner.

"The university is desperately trying to come up with money
to cover the worst scandal in higher education (the conviction
of coach Jerry Sandusky of sexually molesting children and the
resulting $60 million fine and other sanctions). We have to
wonder if the $1,200 penalty is a Sandusky tax."

University spokeswoman Annemarie Mountz said the wellness
program is "totally unrelated" to the Sandusky sanctions, which
are being paid out of a separate budget from the one that covers
healthcare, and that the university's 2009 strategic plan
included reining in healthcare costs.

Those costs are projected to top $217 million this academic
year, $17.7 million more than last year, in a total budget of
$4.4 billion. That works out to $5,425 per insured individual,
compared with a U.S. average of $9,000. The university, which
covers about 40,000 employees at campuses across the state, did
not offer an explanation of why its costs are lower. It is
self-insured, meaning it pays medical claims out of its own
pocket.

'TAKE CARE OF YOUR HEALTH'

Penn State gave its covered employees and spouses until
October to comply with two key requirements of the new "Take
Care of Your Health" wellness program: complete an online
wellness profile from WebMD and undergo a preventive
physical, including tests of cholesterol and glucose levels, and
measurements of height, weight, and waist circumference.

Employees who fail to do both will have $100 per month
deducted from their paycheck.

Penn State is hardly alone in turning to workplace wellness
programs to reduce its healthcare spending; 51 percent of
employers with more than 50 employees offer one. But results
have been disappointing.

In a report requested by Congress and released in May,
researchers at the RAND Corp., an independent think tank, found
that the programs have only a modest effect on health. Employees
who participate in workplace wellness programs lose, on average,
one pound a year for three years, for instance, and
participation "was not associated with significant reductions"
in cholesterol level.

A key determinant in whether a wellness program will yield
net savings is how much an employer spends on illnesses - such
as smoking-related emphysema - that can be reduced by
counseling, preventive care and other elements of wellness.

Averaged across all employees, those "wellness-sensitive
events" cost employers $300 per person per year, said Al Lewis,
president of the Disease Management Purchasing Consortium
International, which helps employers reduce healthcare costs.
Because wellness programs are not magic wands - they don't make
every smoker quit or every obese person slim - they make only a
small dent in that spending, which RAND estimated at $29 per
person per year in the first year and $133 in the fourth, "both
nonsignificant changes."

Highmark projected that the wellness program would keep cost
increases to two percentage points above the rate of medical
inflation which is 2.7 percent so far this year.

'INCREASED UTILIZATION'

For Penn Staters, the WebMD survey includes questions that
may lead to more healthcare spending. The 12-page form, reviewed
by Reuters, asks for data on glucose, cholesterol, weight, about
feeling sadness or guilt, experiencing problems with friends or
supervisors or finances, and a long list of screenings, all of
which can trigger more doctors' visits, invasive tests and
surgery that may not improve health.

"You're looking at increased utilization," said Vik Khanna,
a healthcare consultant in St. Louis and editor of The Health
Care Blog. "There can only be more claims if people fill these
out."

More problematic, he said, the questionnaire includes items
whose relevance to preventing disease has been dismissed by
scientific studies. Women, for instance, are asked if they
conduct regular breast exams. Men are asked if they perform
regular testicular exams and when they last had a PSA test,
which is supposed to detect prostate cancer.

The U.S. Preventative Services Task Force recommends against
all three measures. WebMD spokeswoman Kate Hahn said medical
groups disagree about the value of various cancer screenings and
that WebMD reviews its questionnaire annually, adding or
deleting questions "to reflect changes in national standards."

As part of his campaign of "civil disobedience" against Penn
State, Woessner is suggesting that employees refuse to have
their physical at the mobile vans the university has hired and
instead go to their own physician. For his last full physical in
2012, Penn State was billed $421, including $144 for blood work.

If the 2,000 staff (and their families) who signed a
Change.org petition protesting the program took Woessner's
advice, the university would be hit with more than $1.5 million
in additional costs as a result of the wellness mandate.

Thomson Reuters journalists are subject to an Editorial Handbook which requires fair presentation and disclosure of relevant interests.

This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to colleagues, clients or customers, use the Reprints tool at the top of any article or visit: www.reutersreprints.com.